How much rates vary
Facilitymedian $2,692 · 10th to 90th $186 to $9,550Professionalmedian $288 · 10th to 90th $123 to $562
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $478.63 Median $3,981.07 Typical High $9,332.54 | Facility | None | $478.63 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $407.38 Typical High $562.34 | Professional | None | $144.54 | $407.38 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $354.81 Typical High $537.03 | Professional | None | $123.03 | $354.81 | $537.03 |
CareFirst Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | None | $123.03 | $134.90 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,445.44 Typical High $2,691.53 | Facility | None | $346.74 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $363.08 Typical High $549.54 | Professional | None | $125.89 | $363.08 | $549.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $776.25 | Professional | None | $457.09 | $537.03 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $630.96 | Professional | None | $512.86 | $630.96 | $630.96 |
Medcost Setting Facility Modifier None Typical Low $144.54 Median $239.88 Typical High $776.25 | Facility | None | $144.54 | $239.88 | $776.25 |
Medcost Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $549.54 | Professional | None | $199.53 | $257.04 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $114.82 Median $933.25 Typical High $8,709.64 | Facility | None | $114.82 | $933.25 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $724.44 | Professional | None | $257.04 | $489.78 | $724.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $281.84 Typical High $645.65 | Professional | None | $104.71 | $281.84 | $645.65 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $131.83 Typical High $275.42 | Professional | 52 · Reduced service | $72.44 | $131.83 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $52.48 Typical High $112.20 | Professional | 53 · Discontinued | $29.51 | $52.48 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $194.98 Typical High $416.87 | Professional | 54 · Surgery only | $109.65 | $194.98 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.90 Typical High $83.18 | Professional | 55 · Aftercare only | $21.88 | $38.90 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.30 Typical High $56.23 | Professional | 56 · Pre-op care only | $14.45 | $26.30 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $181.97 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $102.33 | $181.97 | $389.05 |
Where Virginia sits
The same service costs 5.6 times more in Colorado than in North Dakota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $4,763ND $853
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.